Kwashiorkor

Kwashiorkor is a severe form of malnutrition. It's most common in some developing regions of the world where babies and children have a diet that lacks protein and other essential nutrients.

The main sign of kwashiorkor is too much fluid in the body's tissues, which causes swelling under the skin (oedema). It usually begins in the legs, but can involve the whole body, including the face.

Symptoms of kwashiorkor

As well as oedema, symptoms of kwashiorkor can include:

loss of muscle mass

an enlarged tummy ("pot belly")

regular infections, or more serious or long-lasting infections than usual

red, inflamed patches of skin that darken and peel or split open

dry, brittle hair that falls out easily and may lose its colour

failure to grow in height

tiredness or irritability

ridged or cracked nails

Kwashiorkor can be fatal if it's left untreated for too long because children become very vulnerable to infections.

What causes kwashiorkor?

The main cause of kwashiorkor is a lack of protein and other essential nutrients, such as vitamins and minerals.

It's most common in developing countries with a limited food supply, poor hygiene, and a lack of education about the importance of giving babies and children an adequate diet.

Kwashiorkor is rare in developed countries such as the UK, but it can occasionally occur as a result of severe neglect, long-term illness, a lack of knowledge about good nutrition, or a very restricted diet.

Although kwashiorkor can affect people of all ages, it's more common in children than adults.

Diagnosing kwashiorkor

Kwashiorkor can often be diagnosed based on a child's physical appearance and questions about their diet and care.

However, blood and urine tests may be carried out to rule out other conditions. This can include tests to:

measure blood sugar and protein levels

check how well the liver and kidneys are working by testing the urine and blood for anaemia

treating vitamin and mineral deficiencies – vitamin supplements are usually included in the special milks or RUTF

slowly introducing small amounts of food before gradually increasing the amount of food

The whole process usually takes between two and six weeks to complete.

Recovering from kwashiorkor

How well a person recovers from kwashiorkor depends on how severe their symptoms were when treatment began.

If treatment was started early, the person will usually recover well, although children may never reach their full growth potential and be shorter than their peers.

If treatment was started in the later stages of protein malnutrition, the person may be left with physical and intellectual disabilities.

If kwashiorkor isn't treated or treatment is significantly delayed, it can lead to death.

Marasmus

Marasmus is another type of malnutrition that can affect young children in regions of the world where there's an unstable food supply.

Signs of marasmus include thinness and loss of fat and muscle without any tissue swelling (oedema).

Like kwashiorkor, marasmus is caused by a lack of the right types of nutrients. Tests may need to be carried out to exclude other causes of thinness. The treatment for marasmus is similar to that for kwashiorkor.